Good With the Scalpel, but Lacks People Skills

Reading “The Dinner,” by the Dutch author and misanthrope Herman Koch, was rather like being stabbed in the eyeball with a hot needle. The book was such a huge international best seller that Mr. Koch is demonstrably not alone in his fascination with all things loathsome about humanity, and “The Dinner” did tell a propulsive tale. It is a hard act to follow, but say this about his new novel, “Summer House With Swimming Pool”: This is a book in which someone actually does stick a hot needle in his own eyeball. The blood, pus and pain that follow are lovingly described.

The eye stabber is the novel’s main character, Dr. Marc Schlosser, a physician who finds his patients disgusting. Let him count the ways. “Human bodies are horrible enough as it is, even with their clothes on,” he says by way of introduction; then he goes on to describe the humiliation he can inflict by performing a rectal exam. The book’s first chapter ends with the widow of a patient — Marc has no great claims to competence — arriving in his office and spitting in his face.

The widow is Judith Meier, and her husband was a fat, boorish actor who must have sensed a kindred spirit in Marc. Eighteen months before he died, Ralph Meier, a big star, appeared in the doctor’s office partly because Marc is known not to condemn excess weight or drinking as anything worse than bonhomie. And because he writes whatever prescriptions his patients want. And because he is either two-faced or unhinged enough to flatter them no matter what he really thinks.

“ ‘Do you know that you’re very pretty?’ is something you only say to an ugly woman,” Marc tells the reader. (Marc’s outlandish misogyny may help fuel the notion that this is a novel of ideas. Have fun, book clubs.) About the only kind of man who would have sex with such a homely specimen, he describes “filthy, worthless sperm that smells like a half-finished bottle of fermented dairy drink stuck at the back of the fridge and then forgotten.” (Have fun, admirers of beautiful prose.)

In any case, it’s not just Marc and the famous actor who hit it off. Ralph immediately gives the once-over to Caroline, Marc’s wife, just as Marc is sizing up Ralph’s wife, Judith. For a while, this promise of spouse swapping seems innocent enough, especially when the Meiers invite the Schlosser family to visit their summer house with a swimming pool somewhere on the Mediterranean coast. Caroline prefers camping and resists the house at first, which gives Marc a chance to tell the reader how revolting a fellow camper’s big toe with a fungal infection can be. In Marc’s very creepy fantasy life, he tracks this man to the toilet and then corners him, attacking his foot with a hammer. “There would be a blood bath,” he daydreams. “Loose bits of toenail would fly in all directions, against the walls and the low doors of the cubicle, like plaque atomized under a dental hygienist’s drill.”

It must be pointed out that Mr. Koch brought the same kind of vile detail to describing food served in an elite restaurant in “The Dinner.” So at least nobody’s eating here. But “The Dinner” had a multicourse structure: It was coarse and simple-minded but tough. “Summer House With Swimming Pool” is weaker and unhurried, rambling along with no particular destination.

Its main emphases are on filth, lechery and jealousy, in about that order. And they all come into play once the Schlossers reach the beach house and the young Schlosser daughters start getting ogled by every male in the vicinity, from the Meiers’ sons to a cheaply caricatured Hollywood director who prefers about a 40-year age difference between himself and the babes he chases. Ralph is no slouch in the teenage-chasing department himself, and there’s a certain humor in the feeble excuses that get made: Did he pull off the 13-year-old Julia Schlosser’s bikini bottom? Hey, can’t Marc take a joke? Everyone at the house has been playing this fun pants-pulling game.

Mr. Koch none too carefully invests all the adult men in the book with mean streaks, so that when violence breaks out, the perpetrator could in theory be any of them. But this mystery isn’t terribly interesting; more so is the question of just how crazy Marc really is. He has absorbed the ideas of a medical school professor who makes Nietzsche sound like Dale Carnegie.

This teacher’s idea of positive thinking is to accept biological imperatives about man’s need to impregnate as many women as possible, women’s uselessness beyond the age of childbearing, and other mechanistic edicts. No grasp of human behavior penetrates this worldview. But we get the sense that Marc has tried very hard to be something that he is not — and that the person who most revolts him may be himself.

“Summer House With Swimming Pool” reveals at the start that Ralph is dead and that Marc’s medical techniques contributed to his send-off. Anyone looking for a comparison to “Gone Girl,” winner and still champion in the realm of books that begin with deceptive death reports, will find no stiff competition here. Yes, Ralph is dead. Yes, Marc is dangerous. And most of Mr. Koch’s male characters in this book, like most in his last one, genuinely deserve their doom.

A version of this article appears in print on , on Page C4 of the New York edition with the headline: Good With the Scalpel, but Lacks People Skills. Order Reprints | Today’s Paper | Subscribe